Suicide and Self Harm Prevention Briefing Paper for Welsh Government

Compiled by

Bleddyn Jones

Station Commander

South Wales Fire & Rescue Service

Suicide and Self Harm in Wales

In the ten year period between 1996 and 2006 there were three hundred recorded deaths related to suicide in Wales. Since 2007 this figure has risen in Wales and in 2015 there were 350 recorded suicides. This data indicates that suicide is the main cause of death for young people in Wales with the highest rate in the 30 – 34 year age group.  The extent of the problem is not localised but spread across the country and reaches into many different socio-economic groups.

In 2009 the national action plan to reduce suicide and self-harm, called ‘Talk to Me’ was launched to provide an overarching strategy for the forthcoming five year period.  The aim of the policy was to work together to save lives by developing a collaboration between Welsh Government, NHS Wales, local authorities, justice agencies, voluntary organisations, employers, education and community groups.

In this first iteration the Fire & Rescue Service (FRS) were not identified as a ‘Primary Care Giver’.  This may have been due to a lack of awareness of the expanding role of the FRS across Wales.

Talk to Me 2

As a FRS we felt it was important for our role as a care provider to be identified and recognised, we were keen to contribute positively to the excellent work that was ongoing across Wales.

We worked with the leads of the National and Regional groups to provide detail on the vital role we could play in both the mitigation and supporting potential ‘Persons in Distress’.  This work has led to us being included and identified within the second version of the National Strategy, Talk to me 2

Statistics and Data

Data provided by SWFRS Statistics Department shows that over the last three years up to 2017/18, SWFRS have received requests for assistance to thirty two suicide related incidents. Of these 32 incidents, 18 resulted in suicide. Of the 32 incidents 66% were male (21) and 10 of these males were in the age range of 25-40. These figures have seen a steady but small decrease over the last three years. However, this could be due to not being requested to attend by other agencies. 

There have also been 97 water rescue incidents since 2015 and SWFRS can only confirm two of these incidents being the result of suicide. There is an issue across the UK as to how some of these incidents are recorded using differing terminology is used across many different organisations.

Fire & Rescue Priorities

Objective 1: Further improve awareness, knowledge and understanding of suicide and self-harm amongst the public, individuals who frequently come in to contact with people at risk of suicide and self-harm and professionals in Wales.

FRS personnel enjoy a privileged position in terms of the access we have to the communities that we serve.  Through our day to day risk reduction activities we may come into contact with individuals who we identify as being at risk of suicide or self-harm.  As part of our Safe & Well (visits to people homes to provide advice and equipment to reduce fires, smoking cessation, security & scams, carbon monoxide)visit our highly trained staff can identify individuals at risk during discussions relating to health and well-being.  We have a robust referral process in place which is managed by our Safeguarding officer, in conjunction with the children and adult services teams within our ten constituent Local Authorities. 

FRS personnel may come into contact with a ‘person in distress’ who is either threatening to harm themselves or to take their own life.  This can often be seen in scenarios where an individual has placed themselves on a bridge or other elevated position and is threatening to harm themselves by jumping off.  Our staff often found themselves ‘negotiating’ with these individuals or feeling lost for words when they assisted them from a watercourse or bridge.

In order to support them in widening their knowledge we embarked on training our staff in suicide first aid.  We trained 109 staff in Newport across South Wales in Safe Talk and Applied Suicide Intervention Skills as a high proportion of calls to these type of events occur in Newport.  This training was kindly supported by Aneurin Bevan Health Board and Public Health Wales. This has given our staff far greater confidence in talking to potential victims and also identifying people in distress both in the community and the workplace.  We often rely on electronic training systems and encourage our staff to engage in self-study, but we felt that it was important to create an opportunity for face to face training and engagement in role play to enhance the experience.

We are very proud that the British Medical Association endorse this approach as opposed to the reliance on e-learning.  The BMA also go on to highlight the importance of the development of skills in CPR. (Response from BMA Cymru Wales, March 2015). All front line FRS personnel across Wales are trained and certified to carry out CPR as part of their IEC Trauma qualification.

The suicide first aid training has been put to great use both externally and internally and is reflected across the three services in Wales.  We see it as an important part of the suite of options we deliver to maintain the health and wellbeing of our staff across Wales.  Our operational staff can sometimes be expected to deal with situations that may have a lasting effect on their mental health.  In order to mitigate the effects we deliver an immediate response from our specialist team within our Occupational Health Unit (OHU).

Post incident we implement the critical support process whereby individuals can seek specialist support.  This ranges from an informal discussion with a trained practitioner to access to full psychological assessment.  If individuals to not wish to notify the OHU they can access counselling and support through our Employee Assistance Programme through self-referral.   Individuals can seek support from specialist colleagues who operate within our peer support function, the Colleague support Team.  We are also proud of the support provided by our Service Chaplain who can provide not only spiritual guidance but emotional support when required.

All three FRS’ in Wales are proud supporters of the Blue Light Programme delivered by the mental health charity Mind.  We have trained ‘champions’ across all levels of our organisation who are striving to remove the stigma of mental health by provoking discussion and supporting colleagues to be aware of their own mental health and wellbeing. 

We are proud supporters of the Firefighters charity who continue to provide our personnel with access to state of the art rehabilitation services.  Individuals can seek physical rehabilitation and psychological support via self-referral and attend one of the treatment centres across the UK.    

Objective 4: Support the media in responsible reporting and portrayal of suicide and suicidal behaviour

As a FRS we recognise that we cannot fully control the way the media report on the incidents we attend.  We also recognise that if the right information is shared with the media we can attempt to have some influence on the way the message is delivered.

In order to achieve this we have delivered media training to all of our Tactical Officer cadre to enable them to report on incidents more positively and use the correct language.  It is important to consider the likelihood of copycat incidents and the effect any negative commentary may have on the relatives of the deceased. 

We are also in the process of changing the way we categorise incidents involving potential suicide and self-harm.  We are now tagging and categorizing these incidents as ‘Person in Distress’ rather than a more generic term of ‘Rescue from Height’ or ‘Person in Precarious Position’.  We believe that by clearing up the way these incidents are categorised will allow us to provide the appropriate emergency response, report the outcome appropriately in the media and create cleaner more accurate data which will support the identification of trends and hot-spots in the future.  This improved data sharing will support future funding provision for more preventative work and clearly identify the scale of the issue and the extent of emergency service involvement.  

Objective 5: Reduce the meansof access to suicide

Within South Wales the FRS has led on a project to reduce the means of access to suicide by working with partners to implement mitigation measures.  One such project is in Newport where we have led on the delivery and erection of signs on ‘hot-spot’ locations along the River Usk in Newport.  The River Usk is somewhat of a special risk in that it has the world’s highest tidal range of any City River and it can be easily accessed by a series of bridges and walkways.

The options for the types of mitigation measures used by agencies like Network Rail are limited as almost all of the bridges are listed, therefore major restructure works cannot take place.  Supported financially by the Newport SIP board we have erected signs on all bridges along the River Usk which have been provided by The Samaritans.  Evidence suggests that when a person is in distress there is a moment where they are open to an alternative route and we hope the signs will provide a vital lifeline and save lives.  The signs simply offer an individual the opportunity to ‘Talk To Us’ on the Samaritans free phone number.  These signs are widely used by Network Rail across the rail network and stations.

We have also gained agreement from NCP Car Parks in Newport to join the scheme along with the signs being placed in the council operated multi storey car park in the town centre.

The next phase of this project is to affix stickered signs in all public access elevators where members of the public can gain access to roofs and ledges at high level. 

Future Project Work

· Currently in discussion with South Wales Trunk Road Agent (SWTRA) to identify their own high risk areas, erect signs and consider mitigation measures.

· Establish ‘Person In Distress’ as a recognised call type across all emergency services.  This will create better data and better outcomes for the individuals involved.

· Expansion of signs across all tall buildings in Wales to remove the stigma and promote acceptance of the issue and the potential for the person standing next to you in the lift to need this support.

· Increased training provision for all staff across the FRS in Wales.